Safdar Ali Malik, Shumaila Malik, Ayesha Maqbool.
Comparison of transabdominal and transvaginal sonography in the diagnosis of ectopic pregnancy.
Pak J Med Health Sci Jan ;4(1):22-7.

Introduction: Ultrasonography now plays a pivotal role for the assessment of gynecological patients due to its wide-availability, good resolution, low cost and lack of ionizing radiation. Ultrasound gives information about function and morphology of pelvic organs. Objective: To compare transabdominal and transvaginal sonography in the diagnosis of ectopic pregnancy. Study design: Cross-sectional analytic study. Study setting: The study was conducted in the Alnoor diagnostic center, Lahore. Study duration: Study duration was from 1st September 2008 to 15th August 2009. Subjects and methods: 100 hundred patients were included in the study. All women with suspension of ectopic pregnancy were evaluated by both transabdominal and transvaginal sonography. Diagnosis made transabdominal and transvaginal sonography ultrasound was confirmed by histopathology. Sampling technique: Non-probability convenient sampling. Results: Ultrasonographic findings of ectopic pregnancy were seen, including presence of extra uterine gestational sac or complex mass 91 %, absence of gestational sac in uterus 94%, fluid in the pouch of douglus 67%, thick endometrial lining or pseudo gestational sac 35%, enlargement of uterus 6%. More than one finding was seen in several patients. Most common age group with pelvic masses was between 26-30 years. Image quality and anatomic detail were better in 84% cases with TVS and in 54% cases with TAS approach. There was a significant difference in the image quality, between two modalities. Diagnostic information of these modalities was almost equivalent. TAS diagnosed 84% while TVS 93%. Conclusion: TVS is better at detecting subtle abnormalities than TAS. However TAS is important for giving an initial overview of the pelvis and should be performed when the urinary bladder is full. If the TAS closely identifies a live intrauterine pregnancy and normal adenexa or if the TAS detects a live ectopic pregnancy study can usually be stopped. The TAS is also important to look for findings outside of the pelvis, in particular abdominal ascites. TVS usually be used in conjunction with, and not as a substitute for, TAS. TVS is best used when TAS is not conclusive, or when immediate confirmation of an intrauterine pregnancy is desired.

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